• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.815-821
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• 2000

The purpose of this study was to evaluate the influence of accessibility to dental cervices of maxillary molars upon plaque control level of these areas. Fifthy-seven dental students with healthy gingiae participated in this study. Maxillary dental casts were fabricated for each participants. Using the casts, cervical accessibility was measured at the mid-palatal point of maxillary first and second molars. Cervical accessibility was defined as the perpendicular distance from the entrance of gingival sulcus to the imaginary line between the most protruded points of palatal gingiva and tooth surface, and classified into degree I(${\leq}0.5mm$), II($>0.5mm,\;{\leq}1.0mm$), III($>1.0mm,\;{\leq}1.5mm$), and IV(>1.5mm). Plaque score was recorded as the distance from crest of gingival margin to the most coronal extent of plaque. Measurements of plaque score were repeated 3 times at 1-week intervals. After the baseline measurements, the participants began to use unitufted brushes on randomly assigned right or left side. Two weeks later, a session of plaque score records identical to the baseline measurements was started. The maxillary second molars showed higher cervical accessibility than the first molars(p<0.01), but the plaque scores of maxillary second molars were also higher than those of first molars(p<0.01). For the maxillary first molars, correlation between accessibility and plaque score was statistically significant, but such correlation was not found for the second molars. Use of unitufted brushes decreased the plaque score(p<0.01). Correlation between accessibility and the degree of plaque score improvement was not found. These findings suggest that cervical accessibility may influence the amount of plaque, and use of adjunctive oral hygiene devices may be helpful in maintaining optimal oral hygiene level at the areas of low cervical accessib ility.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.271-282
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• 1994

Active treatment of periodontal disease consists of plaque control by the patient, with root planing and surgery perfomed by the dental practitioner. Chlorhexidine rinse has been the most effective antiplaque agent available today and tetracycline has been the most favored antibiotics. Therefore, the purpose of this study was compared the different effect among groups(saline mouthrinse[group I], 0.125% chlorhexidine mouthrinse [groupII], and 0.125% chlorhexidine mouthrinse containing tetracycline[groupIII]) during the immediate post periodontal therapy. We assessed plaque index, gingival index, papillary bleediing index, gingival crevicular volume, periodontal attachment loss, and periodontal pocket depth in 3 sites per subject. The assessment was made at baseline. At 1 week after scaling, and at 2 weeks after curettage. All groups were clinically and statistically reduced plaque score, gingival score, papillary bleeding score, and gingival crevicular volume at 2 weeks after curettage. Group II was significantly reduced periodontal pocket depth.(P<0.05) At 1 week after scaling, al clinical index scores were reduced but not singificantly difference between the groups.(p>0.05) At 2 weeks after curettage, plaque score, gingival score and papillary bleeding score were significantly difference between the groups.(P<0.05) During the experimental period, gingiva was not damaged and stain of the tongue or teeth were not noted in all groups.

• Journal of Korean society of Dental Hygiene
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• v.18 no.5
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• pp.853-862
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• 2018

Objectives: This study involved a non-equivalent control group, pre-test/post-test measurement experiment to evaluate the efficacy of distributing plaque disclosing agents to healthy adults living in South Korea and promoting its self-application. Methods: O'Leary index, PHP index, oral health behavior intention, and oral care satisfaction were used as research tools. A notice was posted on the bulletin board from September 12 to October 15, 2016, to recruit adults aged 20-50 years. Data were analyzed using SPSS Version 22.0, and frequency analysis, Pearson's chi-squared, one-way analysis of variance (ANOVA), Kruskal-Wallis, and repeated measures ANOVA were performed. Results: The O'Leary index was significantly reduced in the group (p<0.01), and time (p<0.01) after education and width of the decrease had the highest score in the group that received education on plaque disclosing only. They were followed by the group that received education on plaque disclosing and the rolling method, the group that received education on the rolling method alone, and the control group. The PHP index significantly decreased in the group(p<0.01) and time (p<0.01), and the group time (p=0.039) after education, and width of the decrease had the highest score in the group that received education on plaque disclosing and rolling method. They were followed by the group that received education on plaque disclosing alone, the group that received education on the rolling method alone, and the control group. Conclusions: Based on the aforementioned findings, the direct use of plaque disclosing had a marked effect on self-oral care. These results suggest that the self-application of plaque disclosing could be an effective self-care method for improving the oral environment.

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.35-44
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• 1995

The purpose of present study was to evaluate the relationship between the early change of gingival condition and methyl mercaptan concentration during experimental gingivitis. Ten men(23-25 years old) whose gingiva were clinically healthy were selected. The participants have ceased to perform all forms of oral hygiene during 14 days and then did thorough plaque control for 7 days. For each subject, the methyl mercaptan concentration was measured by $B.B.Checker^{(R)}$ (Bad Breath Checker with printer, Tokuyama Soda Co.,LTD., Japan)before experiment and 1,4,7,14,21 days during experiment. Plaque index(Silness & $L\ddot{o}e$), gingival sulcus depth and sulcus bleeding index($M\ddot{u}hlemann$ & Son)score were recorded. The results were as follows. 1. Methyl mercaptan concentration increased continuously from the first day to the 14th day, decreased on the 21th day but it was still higher(P<0.001). 2. Plaque index score and sulcus bleeding index score tended to increase on the 4th day, markedly increased on the 14th day and returned to baseline level on the 21th day. 3. There was parallel relationhsip among methyl mercaptan concentration, plaque index score and sulcus bleeding index score. This result suggests that methyl mercaptan concentration increased with deterioration in gingival health, but decreased during recovery of normal health condition.

• Journal of Periodontal and Implant Science
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• v.48 no.1
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• pp.22-33
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• 2018

Purpose: The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods: A total of 116 patients were included in this study. After evaluation of the $L{\ddot{o}}e$ and Silness gingival index (GI), Silness and $L{\ddot{o}}e$ plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. Results: After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was $2.76{\pm}0.71$ times longer than that for MPS measurement after 2 weeks of training. Conclusions: MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.6
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• pp.2088-2092
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• 2010

Educational object of this study was patients who visited H-dental clinic in D-Metropolitan City. It was investigated on the general character, subjective health condition, oral knowledge, oral recognition and oral practice of patients(experimental group 134 subjects and control group 110 subjects) who were educated to repeated directing tooth-brushing through questionnaire. For understanding the degree of actual oral practice, plaque control score was analyzed by the O'Leary index. The results of this study are as follows. A verification of effect after repeated directing tooth-brushing education represented to significance in experimental group on the concern, subjective health condition, oral recognition, oral knowledge, oral practice and plaque control score(p<0.001). And as frequency of repeated directing tooth-brushing education was increased, plaque control score significantly increased(p<0.001).

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.195-204
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• 2004

A novel glucanhydrolase from Lipomyces starkeyi KSM 22 has been suggested as a promising anti-plaque agent because it has been shown to have additional amylase activity and mutanase activity besides dextranase activity and to strongly bind to hydroxyapatite. Mouthrinsing with Lipomyces starkeyi KSM 22 glucanhydrolase solution was comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effects were less frequent and less intense in human experimental gingivitis. In this study, Lipomyces starkeyi KSM 22 glucanhydrolase mouthrinses (1 and 2 unit/ml) were compared with a control mouthrinse (commercial 0.01% benzethonium chloride mouthrinse, $Caregargle^{(R)}$, Hanmi Pharmaceuticals) in the ability to inhibit plaque formation. A 3-replicate clinical trial using 4-day plaque regrowth model was used. Fifteen volunteers were rendered plaque-free on the 1st day of each study period, ceased toothcleansing, and rinsed 2X daily with allocated mouthrinse thereafter. On day 5, plaque accumulation was scored and the washout periods was 9 days for the next trial. Lipomyces starkeyi KSM22 glucanhydrolase(1 unit and 2 unit)- containing mouthrinse resulted in Significantly lower plaque formation in plaque area and thickness, compared to the control mouthrinse. There was no significant difference in plaque inhibition between enzyme-mouthrinses at 2 different concentrations used. This glucanhydrolase- containing mouthwash resulted in significantly lower plaque area severity index score and tended to have lower plaque thickness severity index score than those of control mouthrinse. But there was no significant difference according to the enzyme concentration. From these results, Lipomyces starkeyi KSM 22 glucanhydrolase-containing benzethonium chloride mouthrinse has greater anti-plaque effect than the commercial mouthrinse alone. Therefore this glucanhydrolase preparation is a promising agent for new mouthwash formulation in the near future.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.371-388
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• 2001

A novel glucanhydrolase(DXAMase) from a mutant of Lipomyces starkeyi(KSM 22) has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependentadherent microbial film and DXAMase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi DXAMase are desirable for its application as a dental plaque control agent. This study was performed to determine the adjunctive oral hygiene benefits and safety of dextranase(Lipomyces starkeyi KSM 22 DXAMase)-containing mouthwash when used alongside normal tooth-brushing. This 6-month clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 3 and 6 months, subjects were scored for plaque accumulation(Turesky modification of Quingley-Hein's plaque index), gingivitis status($L\ddot{o}e$ and Silness gingival index), and tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects provided with allocated mousewash and instructed to use 20-ml volumes for 30s twice daily after toothbrushing. All the groups showed significant increase in plaque accumulation since 1 month of experiment. During 6 months' period, the Dextranase mouthwash group showed the least increase in plaque accumulation, compared to the Chlorhexidine mouthwash and placebo groups. As for gingival inflammation, all the groups showed significant increase during 6 months of experiment. The Experimental group(Dextranase mouthwash) also showed the least increase in gingival index score, compared to the Positive control(Chlorhexidine mouthwash)as well as the Negative control(placebo)groups. Whereas the tooth stain was increased significantly in the Positive control group, compared to the baseline score and the Negative controlgroup since 3 months of mouthrinsing. It was significantly increased after 6 months in the Experimental group, still less severe than the Positive control group. As for the oral side effect, the Experimental group showed less tongue accumulation, bad taste, compared to the Positive control group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase provided adjunctive benefits to toothbrushing, comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, with long-term use of the mouthwash. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.401-420
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• 2001

A novel glucanhydrolase from a mutant of Lipomyces starkeyi(KSM 22)has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and Lipomyces starkeyi KSM 22 dextranase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi KSM 22 dextranase are desirable for its application as a dental plaque control agent. This study was performed to determine oral hygiene benefits and safety of dextranase(Lipomyces starkeyi KSM 22 dextranase)-containing mouthwash in human experimental gingivitis. This 3-week clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 2 and 3 weeks, subjects were scored for plaque(Silness and $L{\ddot{o}e$ plaque index and plaque severity index), gingivitis($L{\ddot{o}e$ and Silness gingival index), and at baseline and 3 weeks of experiment, subjects were scored for plaque(Turesky-Quingley-Hein's plaque index and plaque severity index), tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects provided with allocated mousewash and instructed to use 20-ml volumes for 30s twice dailywithout toothbrushing. All the groups showed significant increase in plaque accumulation since 1 week of experiment. During 3 weeks' period, the dextranase group showed the least increase in plaque accumulation of Silness and $L{\ddot{o}e$ plaque index, compared to the chlorhexidine and placebo groups, but chlorhexidine group showed the least increase inplaque accumulation of Turesky-Quingley-Hein's plaque index. As for gingival inflammation, all the groups showed significant increase during 3 weeks of experiment. The dextranase group also showed the least increase in gingival index score, compared to the chlorhexidine as well as the placebo groups. Whereas the tooth stain was increased significantly in the chlorhexidine group, compared to the baseline score and the placebo group since 3 weeks of mouthrinsing. It was significantly increased after 3 weeks in the dextranase group, still less severe than the chlorhexidine group. As for the oral side effect, the dextranase group showed less tongue accumulation, bad taste, compared to the chlorhexidine group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase was comparable to 0.12% chlorhexidine mouthwashin inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, in human experimental gingivitis. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.

• Journal of dental hygiene science
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• v.12 no.6
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• pp.660-665
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• 2012

The purpose of this study was to use basic data of dental hygiene curriculum by comparing the rolling method and modified stillman method. Plaque measurement method, Q-ray examination of the clinical utilization value shall review. True experimental design is randomized controlled trial to the intervention group and the control group. Measurements are plaque control record (PCR; O'Leary index) measurements and Quantitative Light induced fluorescnece Digital (QLFD) shooting as a pre-test was conducted. Intervention group is modified stillman method, control group is rolling method. Intervention after 5 weeks, PCR measurement and QLFD shooting was carried out as a post-test. Rolling method and modified stillman method plaque reduction did not differ. Intervention before and after the results of the comparison showed reduced plaque score after brushing law education. Also, Plaque reduction differences were more pronounced modified stillman method than rolling method. PCR and QLFD values of the correlation was not confirmed but SPS Score and the lower value of the ${\Delta}R$ value of the correlation. Plaque of maturity tooth that are not observed visually.